August 31, 2004

The bedside manners of doctors is one of the elements that will be considered when assessing their competency.

The Deputy Director-General of Health, Datuk Dr Ismail Merican, said doctors must provide evidence that they had the knowledge and skills to be effective, competent, safe and reliable healthcare providers.

The competency assessment will cover all allied healthcare providers, including doctors.

Dr Ismail said what the Health Ministry hoped to implement with its involvement in the Continuing Professional Development (CPD) of healthcare providers was to link the assessment to what they did in their daily routine. “Doctors should not complain anymore about being assessed for competency based on something irrelevant.” He said doctors were unhappy about the competency assessment as they felt that some portions of it were not relevant.

But with the new directive from Health Minister Datuk Dr Chua Soi Lek, he said, the ministry had come up with its own assessment for allied healthcare providers besides that of the Public Services Department (PSD).

“We cannot just promote people with any form of objective assessment. We will start with doctors first. Later, we will rope in the pharmacists, physicists, researchers and other allied health personnel.” He said the competency assessment would also be based on credit points and logbook, meaning doctors would be assessed on how they performed in certain procedures and how they related to patients and others.

The ministry, he added, was working closely with the Section Concerning House Officers, Medical Officers and Specialists (SCHOMOS) and Malaysian Medical Association (MMA) to introduce the CPD activity in the assessment so that doctors would be evaluated on competency. “Doctors must provide evidence that they are armed with the necessary knowledge and skills to be effective, competent, safe and reliable healthcare providers.” He said doctors were happy with this even though the requirements were quite stringent. “They are happy because they feel they would be evaluated based on something that is more relevant to what they do,” he said, adding that they also needed to know some of the government procedures and policies as it was important to their core business.

“Doctors and allied healthcare personnel must be aware of the existing government policies so that they can work within the framework of policy decisions made by the Government.” Dr Ismail said there were doctors and allied healthcare providers who did not know what was going on around them, including the policies within which they had to work. “They must know what they can and cannot do.” He added that the Government was also introducing leadership and strategic planning skills for senior government officers who needed to be trained in the field.

“CPD is important because it will ensure that people are continuously updated and whatever they do is in keeping with the times so that they don’t lose out on skills,” he added.

He said that over the years a lot of things had changed and a lot of new skills and knowledge developed.

“There is also the changing global challenges and the expectation of the public is even greater,” he said, adding that this was why they wanted doctors and those in healthcare to be equipped with the knowledge and skills which they may not have acquired as graduates.

At present, doctors have to undergo examinations and go for courses organised by the PSD.

Although they will still undergo one examination with the PSD, the ministry would conduct its own competency assessment for its staff. Dr Ismail also stressed that the CPD involved doctors in the public and private sectors as well.

He said it was a systematic process of life-long learning and professional development aimed at enabling healthcare providers to maintain and enhance their knowledge, skills and competence for effective clinical practice to meet the needs of the population.

Dr Ismail added that the CPD dealt with issues that were linked with professional competency, provision of quality care and improved health outcomes for doctors in both the public and private sectors.

PATIENTS registered with Putrajaya Health Clinic carry no appointment cards if they possess MyKad, the new chip-based national identity card.

The long queues that are a common feature in most government clinics and general hospitals in the country are unheard of in this futuristic healthcare facility in the nation’s new administrative centre.

A patient with an appointment for the day merely swipes his MyKad at a terminal, which will then dispense a queue number for the doctor attending to his case.

If he has a mobile phone he would have had an SMS reminder the day before, plus pertinent information – such as having to fast for eight hours prior to his visit – if he were scheduled to undergo any laboratory tests.

Dr Wong Kien Seng is particularly proud that the applications are Buatan Malaysia – developed locally by programmers, all of whom are Malaysian citizens.
This is information technology communications at work, realising the nation’s eHealth programme, a flagship application of the Multimedia Super Corridor. The clinic and the 272-bedded Putrajaya Hospital, which provides secondary level care, have become the nation’s showcase of its healthcare services of the future.

And patients could expect further enhancements and refinements, promised Dr Wong Kien Seng, chief executive officer of Kompakar eHealth Tech Sdn Bhd (KeHT), who has been involved in the project from day one. KeHT is a subsidiary of the Kompakar Group.

The Clinic Information System (CIS) has run live in Putrajaya Clinic since November 1999, and the Total Hospital Information System (eTHIS) since November 2000, according to Wong, who is particularly proud that the applications are Buatan Malaysia – developed locally by programmers, all of whom are Malaysian citizens.

The two systems are currently Windows-based. But the hospital is keen on migrating to a Java-powered, open source version that Kompakar is near to wrapping up. An open source system will help the hospital cut costs in that no royalty payments are involved.

Although the open source version is aimed primarily at the China market, Kompakar’s stand is “flavours” – it provides applications that meet the client’s operating platform, whether Windows-based, Unix, or open source.

Wong, with over 10 years of healthcare industry experience, said CIS and eTHIS allowed doctors from the clinic to refer patients to the hospital electronically. Patients need not carry a hard copy of referral with them when visiting the hospital.

The hospital staff are able to preview patients’ initial record – the clinical clerking, investigations’ test and results – and proactively plan for patients’ care prior to their consultation.

In the pipeline is a picture archiving and communications system intended to be used for long-term archiving of medical images. This, coupled with other data culled from the hospital’s records, will enable a decision support system that will help doctors in diagnosis and treatment.

Besides, KeHT is working on a shrink-wrapped version of its CIS application that will be offered as a stand-alone system for the smaller healthcare providers.

Wong said in addition to Putrajaya Hospital and Clinic, eTHIS had also been customised for the Pantai group hospitals in Bangsar (Kuala Lumpur) and Pandan Indah (Selangor).

KeHT is also looking at working with other hospitals within the Bursa Malaysia-listed Pantai group.

August 28, 2004

Kuala Lumpur: One among almost every five Malaysians stands to face serious financial difficulties within just three months if he or she is forced to stop work through illness or accident, a survey has found.

The survey, AIA Life Matters, which tested Asians’ attitude towards insurance and risk, showed that in Malaysia, without any form of critical illness, medical or accident insurance cover, 18 percent of those interviewed admitted they would face financial difficulties in just 12 weeks or less.

They would be almost totally reliant on family support or personal savings, the survey said.

The good news, however, was that Malaysia’s 18 percent was the lowest among the countries covered in the survey which was commissioned by American International Assurance Company Limited (AIA).

In Thailand the figure was 24 percent, while Hong Kong and Singapore both registered 20 percent each.

The survey also found that half of all Malaysian respondents admitted they would be struggling to survive financially in more than 12 months and would face acute financial difficulties in the event of an accident or illness.

The figures were similar to Hong Kong, but less than Singapore at 54 percent and Thailand at 55 percent.

Over 70 percent of the respondents in Malaysia said they would either rely on their family for support, or their personal savings, while around 12 percent hoped for charity and social welfare.

The survey covered 500 people comprising the general public aged 25 and above. In Singapore, the respondents were aged 20 and above. The telephone interviews, which were conducted in the second quarter of this year, was surpervised by Taylor Nelson Sofres.

AIA Malaysia vice president and general manager, Richard Bender, said the survey which would be an annual affair, was aimed at helping AIA design and price its insurance products.

The survey clearly indicates the big risks that people unwittingly take by not having adequate insurance coverage, he said at a media briefing here today.

“People ignore the financial impact on individuals and their families from the potentially high costs of expensive medical treatment, the longer-term implications of respite after-care and the consequences of permanent disability,” he added.

Meanwhile, AIA Malaysia vice president, accident & health department, Chuah Chin Seong said the company would be introducing two new insurance products over the next two months, High Networth Personal Assurance (PA) and Scholar PA. – Bernama

August 26, 2004

KUALA LUMPUR: A specialist register will be set up to ensure these professionals are fully competent, said Health Minister Datuk Dr Chua Soi Lek.

He said the Health Ministry had been working with the Academy of Medicine Malaysia (AMM) to develop the registry.

“The registry will also facilitate interactions, referrals and patient management among fellow specialists in various disciplines, and help members of the public identify the specialists that they want,” he said at the 5th MOH-AMM Scientific Meeting at the Sunway Lagoon Resort Hotel here Thursday.

He said the registry would also ensure only competent foreign specialists were credentialed to practise in the country after the implementation of the Asian Free Trade Area.

KUALA LUMPUR: Local healthcare personnel will have the opportunity to learn from overseas experts on ways to prevent medical errors during an international conference on health risk management next month.

Medico-Legal Consultant Dr M. Ponnusamy said the conference, organised by the Malaysian Medical Association, would touch on topics such as clinical risk management in various fields including haematology, pharmacy, radiology and nursing.

The conference will be held on Sept 4 and 5 at the Putrajaya Marriott. Those interested can log on to http://www.mma.org.my or www. adventcgs.com.

August 25, 2004

BANGALORE-BASED Himalaya Herbal Healthcare will make Malaysia its regional hub as it continues expanding worldwide in the fast growing herbal healthcare industry.

Himalaya Herbal Healthcare, the biggest herbal healthcare company in India, will finally set foot in Malaysia after extending its presence to over 50 countries in the world.

“Malaysia is the first country in South-East Asia we are entering and we plan to make it our regional hub.

“This is because it has a very good consumer base with discerning consumers who are exposed to the best healthcare products in the world,” chief executive officer and president Ravi Prasad said in an interview in Kuala Lumpur yesterday.

Prasad, who is here for the local launch of Himalaya Herbal Healthcare products, said many people still had doubts and myths about herbal products.

“Herbal products are safe and do not have any side effects on consumers. We have combined our herbal products with contemporary science and we spend a huge amount of money on research and development.

“In fact, it usually takes us 8 to 10 years of research and testing before a product is launched.

“We do not believe in using chemicals and all our products are chemical-free,” he added.

Himalaya Herbal Healthcare, one of the top 10 companies in the pharmaceutical industry in India in terms of unit sales, is expecting a 25% growth in revenue from its current US$80mil.

“We expect revenue to exceed US$100mil this year. There is huge potential in the herbal healthcare industry. The global herbal healthcare industry is worth US$63bil and growing at 20% -25% a year,” said Prasad.

KUALA LUMPUR: Natural herbal products are not necessarily safe and effective in treating diseases as they have not undergone tests, said a pharmacologist from University of Strathclyde in Britain.

Dr Brian L Furman said interest in such products was increasing as people were losing faith in conventional medicine.

“Some people in the Britain turn to natural products because they believe it is safe.

“They think that because it is called natural products it is naturally safe. That’s purely a false perception,” he said after delivering a talk “Biomedical Sciences at Strathclyde – Drug Discovery from Natural Products” at Technology Park Malaysia yesterday.

“My conception of herbal (or natural) products is that it is another route to getting a new medicine,” he said, adding that the problem with natural products was that many had yet to go through systematic scientific procedures.

Dr Furham said for some natural products, the amount of active ingredients could change enormously under different conditions, “which means we can’t predict what the dose is going to be.”

He cautioned those using natural products to find out about the amount of active ingredients they could produce, whether they were safe and effective.

He also pointed out the dangers in mixing natural products with conventional medicine which could lead to harmful interactions.

On the prospect of natural products, he said, the pharmaceutical industry was interested in using pure compounds from natural products that could control diseases more effectively.

Dr Furman is currently involved in research of potential anti-obesity agents.

August 24, 2004

Asian nations need not panic over the recent outbreak of the Highly Pathogenic Avian Influenza (HPAI), but instead take concerted long-term measures to contain it, said WHO Western Pacific regional director Dr Shigeru Omi.

He said the countries should further strengthen their surveillance systems on the outbreak to prevent the strain from re-emerging later. “The virus is still circulating among poultry farms and there is always a chance for the virus to gain the ability to transmit on a human-to-human basis.”

“So, people should strengthen their surveillance, but at this point of time, we do not need to panic,” he told reporters.

He was here for the opening of the two-day ASEAN Consultation on the Impact of AFTA on Tobacco Trade and Health forum at Hotel Equatorial Penang Monday. Dr Omi congratulated the Malaysian Health authorities for taking prompt and decisive action to contain the avian flu outbreak.

“Malaysia has done a good job to cull the chickens and has taken immediate action to go to the ground to address the issue. The country has also dealt with the Severe Acute Respiratory Syndrome (SARS) very well, and has learnt from its past experience, the Nipah virus outbreak,” he said.

He added that the WHO was not recommending vaccination for animals as a major cure for the virus because it may give a false sense of security. Health Minister Datuk Dr Chua Soi Lek said the tests on the veterinarian and the three children at the Kota Baru Hospital confirmed that they were free from avian flu.

“They will be discharged soon. And, with this, there are no other suspected avian flu cases in Kota Bharu so far,” he said.

PENANG: The Government will study a proposal to reduce the contents of tar and nicotine in cigarettes by 25% and 13% respectively, Health Minister Datuk Dr Chua Soi Lek said.

He said the move was among several proposed amendments to the Control of Tobacco Product Regulation 1993, under the Food Act 1983, which allows the maximum of 20mg of tar and 1.5mg of nicotine in each cigarette.

“We hope to reduce the level of tar to 15mg and nicotine to 1.3mg in each cigarette when amendments to the regulations are made,” he said after opening the two-day Asean Consultation on the Impact of Afta on Tobacco Trade and Health forum in Penang yesterday.

Dr Chua said the Government would soon extend no-smoking zones to cover places of worship, hotel lobbies and toilets as well as public toilets.

“I have also asked the Energy, Water and Communications Ministry to work with the Health Ministry to control all forms of direct and indirect advertisements by tobacco companies,” he said.

Dr Chua said the Government was keen to establish a Health Promotion Foundation, which would be sustained by “sin taxes” from tobacco and alcohol firms to fund sports, cultural and health promotions and activities.

He also said Malaysia, which had signed the World Health Organisation Framework Convention on Tobacco Control last September, was in the process of ratifying it.